THE DOCTOR'S WORLD

THE DOCTOR'S WORLD; New Book Challenges Theories of AIDS Origins

By LAWRENCE K. ALTMAN, M.D.

Published: November 30, 1999

Is AIDS a disaster inadvertently brought on by humans in the early testing of a polio vaccine in Africa in the 1950's?

This provocative theory seemed far-fetched when it first came to public attention in an article in Rolling Stone in 1992. Most AIDS experts dismissed it after a scientific committee reviewed the theory and deemed the probability very low.

But that panel based its conclusion in part on a published finding that was later shown to be in error. And now a remarkable new book by a British journalist offers tantalizing clues to revive and expand the polio vaccine theory.

In ''The River'' (Little, Brown, $35), Edward Hooper suggests that an experimental oral polio vaccine might have been made with chimpanzee tissue contaminated with an ancestor of the virus that was to cause AIDS. Although he has no medical expertise, Mr. Hooper, 48, has done a prodigious amount of research since 1990. In 1,070 pages, with extensive footnotes, he builds a case based entirely on circumstantial evidence that he accumulated in hundreds of interviews and exhaustive library research.

He finds close coincidence in both time and place between the earliest cases of AIDS and the testing of an oral vaccine developed at the Wistar Institute in Philadelphia and, later, in two laboratories in Belgium. From 1957 to 1960, the vaccine was given to a million people in what are now Rwanda, Burundi and Congo.

If the experimental vaccine was contaminated, nothing could have been done about it because there were no tests for the ancestor virus. And it would have been a one-time event because standard polio vaccines were not made from chimpanzee tissues.

Of 28 cases of AIDS acquired in specified towns in Africa through 1980, 23 were from the same towns where the vaccine was given or within 175 miles of them. The area is the epicenter of the African epidemic, the worst in the world.

And there is precedent for a simian virus's lurking in polio vaccine: millions of Americans were inadvertently infected with such a virus, SV-40, in the 1950's and early 1960's. (Fortunately, it was not harmful.)

In 1967, several laboratory workers in Germany died from the newly discovered Marburg virus after it had been imported in African green monkeys. The virus is harmless for the monkeys but lethal for humans.

The similarities could be coincidence. ''The River'' does not prove his extraordinary theory, nor does it claim to. But it builds a sufficiently detailed case to require serious examination of his theory. Attempts to find answers require extensive research, and in the book and in subsequent interviews Mr. Hooper has offered a long list of suggestions, including laboratory testing of the small amounts of vaccine that still exist after having been stored for more than 40 years. Because the vaccine may have degraded over the decades, performing all the proposed research might still not determine whether it accidentally touched off the AIDS epidemic. And even if a simian virus turned up in the stored samples, it would not prove that it started the epidemic.

Even if the thesis is disproved, Mr. Hooper's research has embarrassed scientists. He has found that leading researchers kept sloppy records and that prestigious peer-reviewed medical journals published reports that omitted crucial details.

Despite a diligent search, Mr. Hooper could turn up no records of what primate tissues were used to prepare the first experimental polio vaccines, which were tested mostly in Africa but also in the United States and Europe.

Except for a negative review in the journal Nature, experts writing in journals have praised Mr. Hooper's diligence and scholarship and the plausibility of the thesis, even if they are skeptical. In Science, Dr. Robin A. Weiss, a London virologist, wrote that Mr. Hooper had written the most exhaustive history of polio vaccine trials and early AIDS cases.

The Wistar Institute, the first independent medical research center in the United States, appointed the 1992 panel to examine the theory that its vaccine might have touched off the AIDS epidemic. Now it says it is trying to find independent experts to do what they were unwilling to do seven years ago, when the panel recommended testing the remaining stocks of the experimental polio vaccine. One aim is to detect evidence of simian cousins of H.I.V.-1, the virus responsible for the overwhelming majority of AIDS cases in the world. A second is to determine the primate species from which the vaccine was prepared.

Ever since American doctors first recognized AIDS in 1981, the origin of the viral disease has been a mystery. Scientists have dismissed many theories, including those that held that the Central Intelligence Agency or K.G.B. concocted it, because they lacked evidence or did not fit the facts.

What is known is that the earliest documented H.I.V.-1 infection is from 1959 in a man in Kinshasa in what was then the Belgian Congo, was later Zaire and is now Congo.

Scientists generally agree that H.I.V.-1 derives from a simian virus in chimpanzees. But the unanswered question is how the virus jumped to humans. The usual view is that passage must have occurred in blood-to-blood contact, like a bite or cut during the slaughter of chimpanzees.